In light of comments last week from Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt on Meaningful Use as a component of the Medicare and CHIP Reauthorization Act of 2015 (MACRA) and the Merit-Based Incentive Payment System (MIPS), Mr. Slavitt and Karen DeSalvo, MD—National Coordinator for Health IT—prepared a January 19th blog post that included the guiding principles of how the Meaningful Use Program will fit in with MACRA implementation.
Mr. Slavitt and Dr. DeSalvo’s blog identified the following principles for the future of Meaningful Use, health IT, and physician value-based payment
- Rewarding providers for the outcomes technology helps them achieve with their patients.
- Allowing providers the flexibility to customize health IT to their individual practice needs. Technology must be user-centered and support physicians.
- Leveling the technology playing field to promote innovation, including for start-ups and new entrants, by unlocking electronic health information through open APIs – technology tools that underpin many consumer applications. This way, new apps, analytic tools and plug-ins can be easily connected to so that data can be securely accessed and directed where and when it is needed in order to support patient care.
- Prioritizing interoperability by implementing federally recognized, national interoperability standards and focusing on real-world uses of technology, like ensuring continuity of care during referrals or finding ways for patients to engage in their own care. They stated they will not tolerate business models that prevent or inhibit the data from flowing around the needs of the patient.
Mr. Slavitt and Dr. DeSalvo’s blog also emphasized several important points for the physician and hospital communities, including how current law requires that HHS continue to measure the meaningful use of Office of the National Coordinator (ONC) Certified Health IT under the existing set of standards. Although MACRA does provide an opportunity to adjust payment incentives associated with electronic health records (EHR) incentives in concert with the principles that they outlined, it does not eliminate the EHR Incentive Program, nor will it instantly eliminate all the tensions of the current system. CMS and ONC vowed to continue to listen and learn and make improvements to these programs based on what is happening in the field.
In addition, MACRA only addresses Medicare physician and clinician payment adjustments. The EHR Incentive Programs for Medicaid and Medicare hospitals have a different set of statutory requirements and are not directly impacted by MACRA. Mr. Slavitt and Dr. DeSalvo will continue to explore ways to align the principles they outlined for physicians with hospitals as well as the Medicaid program.
Moreover, their goal in communicating these principles at this point is to give all stakeholders time to plan for what’s next and to continue to give CMS and ONC input. They encourage the entire community to review the MACRA regulations this year; in the meantime, existing regulations—including meaningful use Stage 3—are still in effect.
The blog also discussed how Congress, in December 2015, provided HHS new authority to streamline the process for granting hardship exceptions under the Meaningful Use Program. This new paradigm will allow groups of health care providers to apply for a hardship exception instead of each doctor applying individually, which should make the process much simpler for physicians and their practice managers in the future. Mr. Slavitt and Dr. DeSalvo promised to release guidance on this new process soon.